Wheelchair users are over twice as likely to be obese as people in the general population. The solution to obesity in the wheelchair user population is the same as it is in the general population, a healthy diet and regular exercise. The limited availability of wheelchair accessible cardiovascular exercise equipment may be contributing to lack of regular exercise in this population. Obesity among wheelchair users has led to secondary conditions such as heart disease and upper extremity (UE) pain and injury. Over half of the wheelchair user population has developed UE pain and injury. Body weight has been found to be a predictor of UE injury, with heavier users being more prone to injury. In addition to losing weight, training users such that they develop the strength and skills to push with less frequent, long smooth strokes is currently recommended to help protect them from developing injuries. The OptiPush Wheelchair Training System (WTS) is a unique and targeted response to the problem of obesity, cardiovascular disease, and UE injuries in the manual wheelchair user population. The OptiPush WTS is a wheelchair-accessible treadmill training system that allows the user to improve cardiovascular fitness, exercise capacity, strength and propulsion technique. The key to the OptiPush WTS is a smart tether system that dynamically links the wheelchair to the front of the treadmill to monitor propulsion technique, provide propulsion assistance and ensure the safety of the user on the treadmill. Propulsion assistance options will allow the user to build up the strength and skills necessary to effectively push uphill. The goals of the pilot project are to develop an OptiPush WTS prototype and evaluate its effect on a group of wheelchair users over a 4-week propulsion-training period. Pre- and post-training evaluations will include exercise capacity, propulsion strength, propulsion efficiency and propulsion biomechanics testing. [unreadable] [unreadable]